Korean J Gastrointest Endosc.  2001 Jun;22(6):449-453.

An Impacted Distal Common Bile Duct Stone Mimicking a Tumor: An Unusual Manifestation of Gallstone Disease

• Chung JP
• Kim SY
• Lee JI
• Lee SJ
• Moon BS
• Lee KS
• Chung JB
• Lee SI
• Kang JK
• Kim KW
• Chi HS
• Noh TW

Abstract

Patients with bile duct stones usually present with biliary pain, obstructive jaundice, ascending cholangitis, or pancreatitis. When endoscopic retrograde cholangiopancreatography (ERCP) is performed, bile duct stones are usually movable and thus easily detected. If a stone in the bile duct presents unusually, it may pose some diagnostic challenges. Recently, we experienced a case of an impacted distal common bile duct (CBD) stone mimicking a tumor which resulted in performing a pylorus-preserving pancreaticoduodenectomy in an asymptomatic 56-year-old man. On ERCP, an obstructing distal CBD lesion did not move even by doing brush cytology. Moreover, the result of brush cytology was positive for atypical cells. A major resective surgery performed after recovery from severe post-ERCP pancreatitis confirmed the diagnosis. Interestingly, this stone caused erosion with acute and chronic inflammation and fibrosis containing foci of mild epithelial dysplasia. We herein report an unusual manifestation of gallstone disease with a review of the literature.

Keyword

Impacted stone; Gallstone; Common bile duct; Pancreaticoduodenectomy; Dysplasia

MeSH Terms

Bile Ducts
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis
Common Bile Duct*
Diagnosis
Fibrosis
Gallstones*
Humans
Inflammation
Jaundice, Obstructive
Middle Aged
Pancreaticoduodenectomy
Pancreatitis